PERTROCHANTERIC FRACTURE FEMUR;

Outcome of surgery in elderly subjects following a dynamic hip screw

Abstract

Background: Pertrochanteric fracture is common in elderly population. The dynamic hip screw is widely accepted in the
treatment of P/T fractures of the proximal femur. Objective: The purpose of this study was to assess radiological and clinical union in
elderly patients after operative treatment of a pertrochanteric femoral fracture with DHS. Design: A prospective study. Setting:
Orthopaedic surgery department of Independent Medical College Faisalabad. Study Period: Between July 2009 and June 2012. Method:
The study group included 22 males and 51 females aged 50-95 years following pertrochanteric fracture femur either stable or unstable.
Relevant history and x-rays were taken. We followed the inclusion and exclusion criteria. All patients were operated on routine operation
list under image intensifier after necessary investigations and fitness for anaesthesia. All the cases were treated by closed/open
reduction and a dynamic hip screw (DHS) was inserted by a standard technique. An outpatient follow-up with x-ray check-ups was
carried out at one-month, 3months, 6 months and after 1year intervals to assess union and walking ability as outcome measures.
Results: 73 cases were included in study 22 males and 51 females.66 fractures (90%) healed at an average of 12 weeks postoperatively
(range 8-28 weeks). There were 4 patients (5.47%) requiring further surgical intervention. No obvious shortening of more than 1.6 cm
was noted compared to the contra lateral normal limb. Our results suggest that fixation with DHS may allow a faster post-operative
restoration of walking ability. Mortality upto1 year 11(15.06%).Further 6(8.22%) patients were lost to follow up. Conclusion: It is
concluded that the Dynamic Hip Screw is safe, suitable and reliable fixation.